Nunes Rui, Rego Guilhermina, Brandão Cristina
Department of Bioethics, Faculty of Medicine, University of Porto, Estrada da Circunvalação, n. 9925, 4250-150, Porto, Portugal.
Med Health Care Philos. 2009 Aug;12(3):257-64. doi: 10.1007/s11019-008-9177-4. Epub 2009 Jan 11.
The increasing costs of healthcare delivery led to different political and administrative approaches trying to preserve the core values of the welfare state. This approach has well documented weaknesses namely with regard to healthcare rationing. The objective of this paper is to evaluate if independent healthcare regulation is an important tool with regard to the construction of fair processes for setting limits to healthcare. Methodologically the authors depart from Norman Daniels' and James Sabin's theory of accountability for reasonableness and try to determine if new regulatory models-namely independent agencies-perform better with regard to the public disclosure of the reasons and rationales of healthcare rationing. In publicly financed healthcare systems independent regulation is an important tool to assure fair and reasonable procedures of prioritising services. In accordance with the principle of public accountability, independent regulatory agencies are particularly well suited to assure publicity of the decision-making processes, relevance of the rationale involved and particularly mechanisms for challenge and dispute resolution regarding limit setting decisions. It follows that independent healthcare regulation could be regarded not only as an instrument for performance improvement but also as a tool of social justice. The authors conclude by stating that accountability for reasonableness should be regarded as a landmark of any healthcare reform. And therefore regulators have the social task of assuring that the rationales for limit-setting decisions are clearly accessible to the public.
医疗服务成本的不断增加促使人们采取不同的政治和行政手段,试图维护福利国家的核心价值观。这种方法存在诸多有据可查的弱点,尤其是在医疗资源配给方面。本文的目的是评估独立的医疗监管对于构建公平的医疗资源限制设定程序而言是否是一项重要工具。从方法论角度来看,作者们以诺曼·丹尼尔斯(Norman Daniels)和詹姆斯·萨宾(James Sabin)的合理性问责理论为出发点,试图确定新的监管模式,即独立机构,在医疗资源配给的理由和基本原理的公开披露方面是否表现更佳。在公共资助的医疗体系中,独立监管是确保服务优先级排序公平合理程序的重要工具。根据公共问责原则,独立监管机构特别适合确保决策过程的公开性、所涉基本原理的相关性,尤其是关于限制设定决策的质疑和争议解决机制。由此可见,独立的医疗监管不仅可被视为提高绩效的工具,还可被视为社会正义的工具。作者们最后指出,合理性问责应被视为任何医疗改革的一个里程碑。因此,监管机构负有一项社会任务,即确保公众能够清楚地了解限制设定决策的基本原理。